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General NPI Number Information
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NPI Number | 1205616349
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Entity Type | Individual
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Provider Name | ANJELICA SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 1968 PEACHTREE RD NW
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City | ATLANTA
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State | GA
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Zip | 30309-1281
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Country | US
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Telephone | 470-788-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 238 LEBOEUF ST
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City | NEW ORLEANS
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State | LA
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Zip | 70114-1314
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Country | US
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Telephone | 504-289-3060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP001648
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NP001648
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License Number State | GA
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